Medicare Compliance & Audit Readiness Lead

GRP SCAN Group; California; Hybrid; USD 92,000 - 134,000; Full time

Benefits offered by this job

Annual bonus

Wellness program

PTO & holidays

401(k) match

Tuition reimbursement

Employee recognition

Job summary

SCAN Health Plan is seeking a Medicare Compliance Project Manager to lead audit readiness and coordinate regulatory audits (CMS and state regulators). The role ensures accurate, complete, defensible materials and manages CAPs from identification through closure.

The ideal candidate will coordinate cross-functional teams, track corrective actions, and maintain audit documentation while aligning with regulatory expectations. This position emphasizes collaboration, accuracy, and timely responses.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience.
• 3–5 years of experience in healthcare compliance, auditing, regulatory affairs, risk management, project management, or related field.
• Experience coordinating complex projects involving multiple stakeholders and deadlines.
• Experience supporting audits, examinations, corrective action plans, or compliance oversight activities.
• Strong organizational, analytical, and communication skills.
• Experience supporting CMS Program Audits, Financial Audits, Validation Audits, or other regulatory reviews.
• Experience developing, tracking, validating, or monitoring corrective action plans (CAPs).
• Experience supporting compliance issue management, audit readiness, or regulatory response activities.
• Experience maintaining audit universes, evidence inventories, or regulatory documentation repositories.
• Project Management Professional (PMP), CHC, CCEP, or CIA preferred.

Responsibilities

• Audit Readiness Support – prepare and organize documentation, audit universes, and supporting evidence.
• Audit Universe Maintenance & Validation – review program audit universes for data integrity and gaps.
• Regulatory Audit Leadership & Coordination – lead coordination of audits from intake through close.
• Audit Documentation & Response Management – compile and submit audit documentation.
• CAP Development Support – document findings and assist with root cause analysis.
• CAP Tracking & Monitoring – track CAP activities and status updates.
• CAP Validation & Effectiveness Review – validate corrective actions and updated procedures.
• PCI Tracking – support intake and tracking of potential compliance issues.
• PCI to CAP Alignment – evaluate issues into formal CAPs.
• Audit Reporting & Committee Support – prepare status updates and dashboards.

Skills

Regulatory audits

Project management

CAP tracking

Analytical thinking

Communication

Relationship management

Regulatory knowledge

Data documentation

Education

Bachelor's Degree

Job description

SCAN Health Plan is seeking a Medicare Compliance Project Manager to lead audit readiness and coordinate regulatory audits (CMS and state regulators). The role ensures accurate, complete, defensible materials and manages CAPs from identification through closure.

The ideal candidate will coordinate cross-functional teams, track corrective actions, and maintain audit documentation while aligning with regulatory expectations. This position emphasizes collaboration, accuracy, and timely responses.